A 25-year-old man presents with a rash on his knees. This had gradually worsened over three years. In addition, he had previously had dandruff and more recently noticed his nails changing, for which his GP treated him for a fungal nail infection, but with no improvement. He is a smoker and drinks 35 units of alcohol per week. He has noticed an improvement during the summer months and has also developed pains in his elbow and knees. His sister had a similar rash over her elbows.
Examination There are erythematous plaques on his knees with clearly defined borders and overlying thick scale (Figure attached). There is fine scale throughout the scalp and in his external auditory canals. Examination of his finger nails reveals three nail plates with pitting and onycholysis. What is the likely diagnosis? *This case is from Docplexus editorial team for educative purpose only Source: cases in…
